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4520 Centerville Rd Vadnais Heights MN 55127-3602 | |
(651) 426-1141 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 4520 Centerville Rd, Vadnais Heights, Minnesota |
Authorized Official Name and Position | Jerry L Massmann (CFO) |
Authorized Official Contact | 6128136113 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2910 Centre Pointe Dr Roseville MN 55113-1182 Ph: (651) 855-2109 | 4520 Centerville Rd Vadnais Heights MN 55127-3602 Ph: (651) 426-1141 |
NPI Number | 1477869311 |
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Provider Enumeration Date | 08/30/2010 |
Last Update Date | 10/31/2022 |
Identifier | Type | State | Issuer |
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1477869311 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | 347125 (Minnesota) | Primary |
Minnesota Natural Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3485 Willow Lake Blvd, #100, Vadnais Heights, MN 55110 Phone: 651-484-5567 | |
Northeast Pediatric Clinic P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4520 Centerville Rd, Vadnais Heights, MN 55127 Phone: 651-426-1141 Fax: 651-426-1705 | |